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Association between Alcohol Consumption and Survival in Colorectal Cancer: A Meta-analysis.
Kim, Y, Je, Y, Giovannucci, EL
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2019;(11):1891-1901
Abstract
BACKGROUND Although an association between alcohol consumption and risk of colorectal cancer is well established, little is known about the association between alcohol consumption and colorectal cancer survival. We conducted a meta-analysis of prospective cohort studies to quantitatively assess this association. METHODS Data searches were performed using PubMed and ISI Web of Science databases through December 2018. We estimated pooled RRs with 95% confidence intervals (CI) using random-effects models. RESULTS Twelve studies with 32,846 patients with colorectal cancer were included in the meta-analysis. Compared with no alcohol consumption, light (RR = 0.87; 95% CI, 0.81-0.94) and moderate (RR = 0.92; 95% CI, 0.85-1.00) prediagnostic alcohol consumption were associated with lower risk of all-cause mortality. Light prediagnostic alcohol consumption was associated with lower risk of colorectal cancer-specific mortality (RR = 0.87; 95% CI, 0.78-0.98). However, heavy prediagnostic alcohol consumption was not significantly associated with colorectal cancer survival. In a dose-response analysis, a nonlinear association between prediagnostic alcohol consumption and all-cause mortality was observed (P nonlinearity = 0.0025), showing the reduction in RR at <30 g/day of alcohol consumption. By type of alcohol, wine consumption was associated with lower risk of mortality from all-causes and colorectal cancer, but a positive association was observed between moderate liquor consumption and all-cause mortality. There was no association between postdiagnostic alcohol consumption and colorectal cancer survival. CONCLUSIONS Light and moderate prediagnostic alcohol consumption were associated with better survival in colorectal cancer. IMPACT Our findings suggest that light and moderate alcohol consumption may be associated with better survival in colorectal cancer, but further studies are warranted.